Discussion of Provider Reimbursement

Discussion of Provider Reimbursement

Instructions/Descriptions

Discussion of Provider Reimbursement Options in Unit 3

Unit 3 Assignment 1: Reimbursement Options (4009 Reimbursement Options)

Instructions

The following scenario is used to make this assessment:

• Patient scenario: Your practice is seeing a new patient for the first time ($500 for a new patient consult).

In your job as a payment specialist for a major primary care practice, describe the various reimbursement methods available to the practice’s providers.

At least three scholarly sources should be used to back up your claims. This may necessitate extra independent investigation on your part. Before you do any additional research, you should examine the Health Care Administration Undergraduate Library Research Guide.

There are two sections to this evaluation.

[Order Now]

Part 1: Reimbursement Options for Providers

Present (at least) the four main reimbursement choices that your provider would have for a new patient consult in the scenario. Describe the options and comment on any potential downsides or other factors to consider for each model. Consider the likelihood and difficulties of recouping the entire consult fee for the patient.

Criteria to use as a scoring guide:

• Outline the disadvantages of the fee-for-service reimbursement paradigm.
• To “describe” someone or something implies presenting a written description of all important attributes, qualities, or events.
• Outline the disadvantages of the capitation reimbursement approach in terms of providing complete services.
• Explain the impact of pay-for-performance on reimbursement rates.
• Explain how a resource-based relative value scale or case-based payment encourages excessive service utilization.
• Follow all grammatical, use, and mechanics rules.
• The term “grammar” refers to the fundamental rules that govern how sentences are built and how words are combined to form sentences (for example, word order, case, and tense).
• “Usage” refers to proper word choice and phrasing, especially when it comes to word and phrase meanings.
• The term “mechanics” relates to the proper application of capitalization, punctuation, and spelling.

[Order Now]

• Format in-text citations and references according to APA guidelines.
• Include a separate page for references.

This section could be organized in the following way

• Fee-for-service.
• What exactly is it?
• Consider health-care spending and cost containment; what are the model’s drawbacks?
• Capitation.
• What exactly is it?
• What are the potential disadvantages of this paradigm for doctors who want to give complete care to their patients?
• Rewarding good performance.
• What exactly is it?
• What effect does this model have on reimbursement rates?
• Relative value scale depending on resources or case-by-case payment
• What exactly is it?
• How does this approach encourage excessive use of services?

Part 2: Uninsured Patients’ Payment Options

If the patient in for the new patient consult is uninsured, identify and describe the potential payment methods accessible to the patient and your care provider. Also, be sure to go over how a patient can be eligible for certain payment alternatives, as well as the reasoning behind the associated appointment fee.

Criteria to use as a scoring guide:

[Order Now]

• Describe the payment choices available to uninsured patients, as well as how the patient would be eligible for each option.
• The word “explain” means “to make obvious” (an idea, issue, or problem) to someone by giving more details or providing pertinent facts or concepts.
• Follow all grammatical, use, and mechanics rules.
• Format in-text citations and references according to APA guidelines.

This section could be organized in the following way:

• Medicaid.
• How does the patient meet the criteria?
• Possibilities for financing.
• What exactly is this technique?
• Self-pay.
• How will the patient be compensated? Is it better to take a percentage of commercial contracts or a portion of Medicare payments?
• Charitable services.
• How would you determine if a patient qualifies for charity care?
• How would you go about qualifying a patient for charity care?

Requirement for Additional Submissions

• Format: Use the given Reimbursement Options template [DOC]. When submitting your assessment, remember to include a title page and a references page.
• Length: 3–5 pages, plus a title page and a list of references.
• References: Include at least three recent scholarly or professional sources in your reference list.
• One of the three textbooks can be yours.
• Use APA style just for references and citations. Please see:
• APA Style Paper [DOCX] Tutoria
• In the courtroom navigation panel, there are more APA resources.
• 12-point Times New Roman font, double-spaced

Discussion of Provider Reimbursement

PLACE THE ORDER WITH US TODAY AND GET A PERFECT SCORE!!!